Jan Cleans Out Files, Comes Up With Blog Entry

I have a "temp" folder inside my "DSM Blog" folder on my computer. When I run across something that looks interesting, I put it in there. Another folder is labeled "pending," which is where I jot down ideas. Sometimes I can’t immediately figure out what to do with those ideas—or something else comes along.

Judging from the snow and ice outside my window, it isn’t spring yet, but it’s as good a time as any to do some cleaning.

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“Media hysteria rather than hard science resulted in black box warnings on supposed dangers of thiazolidinediones for treatment of patients with diabetes, some doctors [at an industry-sponsored meeting in Orlando, FL] suggested,” begins an article on whether or not rosiglitazone (brand name Avandia) and pioglitazone (Actos) contribute to cardiac problems.

“There is still a lot of confusing data,” one doctor said.

And, another opined, studies weren’t all that good and, besides, there weren’t all that many adverse reactions.

Interestingly, all but one of the doctors quoted cited possible financial conflicts of interest with one or more pharmaceutical companies—including Takeda, which developed Actos and, incidentally, supported the symposium.

Actually, if you’re into reading medical research, scroll down and read the end first. That is, the place where authors declare any conflicts of interest. Then read the article with that information in mind. Sometimes you wonder…

(In case you don’t know, a common adage in journalism school is “If your mother says she loves you, check it out.”)

Anyway, I sometimes get a chuckle out of comparing disclosures with results.

The other side of the equation comes from Tara Dairman’s blog entry, “Study Finds New Risks for Avandia.” Down toward the bottom, it says, “Steven Nissen, M.D. …pointed out that the large size of this new study and the fact that it was conducted independently, without sponsorship from any drug company, count in its favor.”

‘Nuff said.

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Check my feet every day? Why am I supposed to check my feet every day? What am I looking for? And, most importantly, what do I do if I find it?

Sometimes, that’s the end of the instructions. Or, should I say, “orders.” We’re sometimes told what to do, but not why and, even more frustratingly, what to do about “it” if we find “it.”

Here’s where we need to take a deep breath and insist that the person in the white coat ‘splain what he or she is talking about. That person usually is not there out of the blue. That person is being paid to be there. By you.

Diabetes is not a “take this pill and it’ll go away” disease: It’s a lifelong condition that must be cared for by us. We’re the ones who will be affected if something goes wrong. We need the tools to enable us to know why things need to be done so we can realize their importance. We need to know what to do in case something does go awry.

If there is something you need to know about, don’t be bashful. Speak up. Ask until you understand the answers.

Whose life is it, anyway?

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I don’t recall where I saw it, but I have a note jotted down saying that the average person faces 200 food-related decisions during the day. Only 200, huh? Lucky “average person.”

I’m assuming there that the average person doesn’t have diabetes, so think about how many more decisions we have to make.

The average person does not have to mentally or physically weigh, measure, or count his food. The average person doesn’t have to match the amount of food he eats with oral medicines or insulin. The average person doesn’t have to take pre- or postprandial blood glucose measurements into account and make the appropriate corrections.

And the one I’m most jealous of—the average person doesn’t have to commit math every time he or she wants to grab a nosh.

Back in the day, when I took two injections a day of Regular and NPH insulin and had to eat specific amounts of carbohydrate at specific times, I had an occasional meltdown. I remember running into the bedroom one day crying, “I can’t do this any more!”

Luckily, I made an excellent choice when it came to picking a husband. He appeared shortly with a tray containing my lunch—with, of course, the appropriate amounts of carbs and fat. Canned soup and a sandwich never tasted so good.

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I don’t like being called a “patient.” I’m a person. Besides, I’m not very patient, as in “able to put up with pain, troubles, difficulties, hardship, etc., without complaint or ill temper,” as this Bible dictionary puts it.

So I looked up other definitions of “patient” and found out that, indeed, a patient is “a person who requires medical care,” an “individual for whom a health insurance claim is being submitted,” and the like.

But my favorite definition came from Wikipedia, which pointed out: “In linguistics, a grammatical patient is an entity upon whom an action is carried out. …For example, in the sentence ‘Jack kicked the ball,’ ‘the ball’ is the patient.”

In which case, I don’t mind being a patient, ’cause I sure have felt kicked around at times.

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Eric

Hi Jan,

Somewhere in your temp folder you may also want to add the thing I’ve been considering writing about at some point (but don’t know that I ever will): “Time Spent Checking Blood Glucose.” I wonder what it would work out to for a month, a year, and 5, 10, and 20 years? Say I check 10 times a day (I do), and say that checking takes from start to finish (as well as how you define “start” and “finish,” about which I could find all sorts of beginning and ending markers), and each bg check takes 90 seconds start-to-finish. Okay, so only 15 minutes a day checking blood glucose. Not too bad. Let’s say that I have times when it takes longer (stopping what I’m doing, getting up to get the kit, correcting the bg, etc.): I average about two hours a week doing these tests. So… a little over four days of each year is spent on ONLY checking my blood sugar. That’s about three weeks every five years, a month and a half every decade.

yep. broken down and looked at writ large, that’s me with a lot of finger sticks and drops of blood (how much blood? buckets? how many strips, and what if you lined them up end to end?) FUN!

Jan Chait

Yikes, Eric! I’d have to commit math! I’m shuddering just thinking about it! I mean, how much *is* a “drop in the bucket,” anyway?

Seriously, not a bad idea. But let’s not limit it to checking blood glucose. How much time does it take to do all of the things related to diabetes? And what are all of those things? And what counts? Should exercise count? After all, everybody–with or without diabetes–is supposed to exercise.

OK, gang – what do you do for diabetes, and how long does it take? It’s OK. I have a brother who’s an engineer. He has a math gene or two and is usually willing to help.

Cathy

Jan, I am so glad to know that somewhere in this world is a real person who struggles with their regimen daily like I do. I am thrilled to know that I am not the only “bad” patient out here. My endo acts like I am insulting him personally when my numbers don’t meet his specs. He has been known to even pout about it. I had to remind him last time that I already have a Father and I don’t need another one. He should know that I am trying every day to meet the mark – some days I do better than others, I admit. Some doctors act like it should be the easiest thing in the world to always be within the guidelines. Maybe I could find an endo with diabetes him/herself and see how well they cope. Thanks for letting me vent! Felt great! Now back to math.

Jerry E

Thanks Jan (and others) for things tothink about. Just a comment, I’ve haddiabetes (type II) for 15 years. Don’twe all, diabetic and non-diabetic havelives to lead with some type of trial ortribulation. We have choices to make inregards to the management of our lives, however, other folks (normal ??) also have decisions to make in regards to their lives.

We all have various layers of decisions to make, some of us more than others. It could be our weight, a drug problem, a relationship problem, moral issues, etc. In the end, our own issues are important to each of us individually. I think it helps to mitigate our individual issues by reaching out to others.

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